摘要:

The autors pointed out that contamination may be exogenous, as a result of invasive diagnostic techniques, patient preparation, surgery, catheter insertion and wound dressing, or endogenous, especially in patients with specific risk factors (age, metabolic disorder, malnutrition, immunodeficiency) and aspecific risk factors (anesthesia, blood transfusion, surgery). Pharmacologic prophylaxis of infection may be unspecific (artificial nutrients, anticoagulants, immunomodulators) or specific (antibiotics). Prophylaxis is indicated in clean-contaminated and contaminated surgery; antibiotic chemoprophylaxis is also indicated in risk patients and permanent prosthesis surgery. The authors emphasized that antibiotics are no substitution for careful surgery.

ISSN:0014-312X    

DOI:10.1159/000129051

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Present data available on ceftriaxone (Rocephin®) dealing with microbiology, pharmacokinetics (long half-life, tissue penetration ability, tissue concentration present during vulnerable period, etc.), results of clinical trials, and world-wide experience seem to be in favor of ceftriaxone as the antimicrobial of choice for single-dose antibiotic prophylaxis in abdominal and biliary surgery. Single-dose surgical prophylaxis is cost-effective, has a low rate of adverse drug events, and so far does not increase danger of resistance

ISSN:0014-312X    

DOI:10.1159/000129052

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Administration of the proteinase inhibitor eglin C reduces the symptoms of capillary leakage in a porcine model of septic shock. This was assessed by measurements of blood pressure, plasma protein concentration, hematocrit, and duration of urine production. Eglin C plasma levels around 1.2 µM resulted from a dose of 1.9 mg·kg–1·h–1 for 4 h and were therapeutically effective. A higher dose of eglin C (7.7 mg·kg-1·h–1 for 4 h) induced levels of approximately 5.6 µM in plasma and was not superior. This observation indicates that lysosomal proteases from neutrophils or degranulation of mast cells play a crucial role in the increase of capillary permeability during

ISSN:0014-312X    

DOI:10.1159/000128998

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

Sixty patients admitted to the hospital for colorectal surgery were randomly assigned to prophylaxis either with a single dose of ceftriaxone (Rocephin®) i.v. plus metronidazole given 30 min prior to induction of anesthesia or with multiple doses of ceftazidime plus metronidazole given repeatedly every 8 h up to 24 h after surgery. The overall number of infections observed with the long-acting cephalosporin ceftriaxone was 4 (2 local and 2 remote), with the short-acting ceftazidime the number was 9 (5 local and 4 remote). Neither regimen was associated with adverse reactions

ISSN:0014-312X    

DOI:10.1159/000129054

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The risk of overwhelming infections is greatly increased after splenectomy. In this experimental study in rats, we investigated whether the administration of fibronectinrich cryoprecipitate can improve the survival rate of splenectomized autotransplanted rats subjected to an intravenous challenge with endotoxin. Inbred Lewis rats were divided into four groups: A, splenectomy; B, splenectomy + splenic autotransplantation; C, splenectomy, splenic autotransplantation + fibronectin treatment, and D, sham. Five months after surgery, rats were challenged intravenously with Escherichia coli endotoxin. Immunoglobulin (IgG, IgM, IgA), complement and fibronectin levels were measured before surgery and endotoxin challenge, and 48 h after endotoxin challenge. The survival rate of splenectomized rats was not significantly improved by autotransplantation of splenic tissue, but was significantly (p < 0.05) improved by autotransplantation and fibronectin treatment. The levels of fibronectin, immunoglobulins and/or complements were significantly decreased after endotoxin challenge in control and in autotransplanted fibronectin-treated rats. The survival improvement of autotransplanted rats treated by fibronectin is probably due to increased endotoxin phagocytosis and clearance.

ISSN:0014-312X    

DOI:10.1159/000128999

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The efficacy of single-dose (1 g i.v.) ceftriaxone (Rocephin®) was evaluated in 175 patients undergoing emergency cesarean section (62 patients) or elective cesarean section (113 patients). The overall rate of postoperative infectious morbidity was 8% (14/175), with 9.6% (6/62) of the group undergoing emergency surgery and 7.0% (8/113) of the patients choosing elective cesarean section

ISSN:0014-312X    

DOI:10.1159/000129055

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

In this multicentre study, 883 evaluable patients undergoing orthopedic surgery were randomly assigned to receive antiinfective prophylaxis with either ceftriaxone (Roce-phin®) or cefamandole. 25 patients in the ceftriaxone group and 29 patients in the cefamandole group (5.6 vs 6.5%) presented with infectious complications within the first 60 days after surgery. Delayed deep wound infections developed in only 1 of 435 patients in the ceftriaxone group compared with 4 of 413 patients in the cefamandole group. Both drugs were well tolerated. The infection rate was twice as high after surgery in conventional operating theatres than after treatment in hypersterile operating theatres (3.3 vs 6.5%); this difference is not statistically significant

ISSN:0014-312X    

DOI:10.1159/000129056

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

1,480 patients, undergoing elective orthopedic and traumatic surgery, received intragluteal injections of ceftriaxone (Rocephin®) to prevent bacterial infections. Postoperative local infections were observed in only 0.5% of the patients. No adverse reactions to the drug were recorded

ISSN:0014-312X    

DOI:10.1159/000129057

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

The dose and time dependence of in vitro endotoxin-induced activation of complement was studied in citrated pool plasma at 37 °C. C3 activation fragments (C3act) and the fluid-phase terminal complement complex (TCC) were used as indicators of initial and terminal activation, respectively. At 1 h marked elevation of C3act and TCC were found in plasma tested with the highest doses of endotoxin (2· 109 and 2· 108 ng/l). In test plasmas with 2 · 107 and 2 · 106 ng/l of endotoxin, no sign of activation was seen during the first 4 h, whereas both C3act and TCC values were increased at 12 h. In thest plasma with 2· 105 ng/l of endotoxin and in control plasma no elevation of TCC values were seen during the observation period (24 h), whereas C3act values increased slightly and to the same extent in both at 24 h. Parallel to the increases in C3act and TCC concentrations, the functional C1 inhibitor (C1INH) values decreased. Changes in C1INH values, however, occurred with a time lag of approximately 6 h compared to the increases in C3act and TCC. Our in vitro study showed a dose-dependent endotoxin-induced activation of both the initial and the terminal part of the complement cascade evaluated by C3act an

ISSN:0014-312X    

DOI:10.1159/000129001

出版商:S. Karger AG    

年代:1989

数据来源: Karger

摘要:

We analysed eight prospective randomized trials describing the use of ceftriaxone (Rocephin®) in short-term prophylaxis in patients undergoing urologic surgery. The results of these trials show that chemoprophylaxis with ceftriaxone is effective. In the therapy of postoperative infections in urologic surgery the single daily dose of ceftriaxone represents a considerable advantage both regarding patients’ compliance and clinical convenience. From March 1987 to January 1988, 25 patients with postoperative infections after urologic surgery were treated with ceftriaxone 1 g i.m. once daily. Quick resolution of signs and symptoms of infection occurred in all cas

ISSN:0014-312X    

DOI:10.1159/000129058

出版商:S. Karger AG    

年代:1989

数据来源: Karger